A Common Factors Approach to Psychotherapy Training

This article addresses training in psychotherapy integration from the perspective of common factors. Problems related to this training perspective are first reviewed. As an attempt to deal with such problems, current teaching and supervision efforts by the author are briefly described. Based on a developmental model of clinical learning, a sketch of a more comprehensive program of integrative psychotherapy training is advanced.     

The WebQuest: An Illustration of Instructional Technology Implementation in MFT Training

This teaching case illustrates the innovative application of an instructional technology modality, the WebQuest, in family therapy training. It describes what a WebQuest involves, and how it can be used as a tool for developing critical thinking and application of contemporary marriage and family therapy (MFT) theory to social and global issues. The authors discuss the results of the survey and focus groups conducted to assess the value of this assignment from the students’ perspectives. Results indicate that its application in a family therapy theories course fostered students’ awareness of global issues impacting family life, integration of family therapy theories to serve children and families, creativity in developing their own intervention models, and ability to discuss and integrate knowledge from different knowledge bases and perspectives.     

内科学临床医学专业学位研究生临床能力培养探讨

结合医院临床教学实践,分析临床研究生培养中暴露的问题,如研究生临床基础薄弱、实践机会减少、带教老师不够 重视等.提出了研究生临床能力培养的几点策略,加强“三基”培训、采用多样化教学方法、联合培养研究生、加强沟通能力培训、提高带教老师素质等,以提高临床医学专业学位研究生的临床能力,确保培养质量.     

Experiential Exercises in MFT Training: Gender, Power, and Diversity

An experiential exercise that is used to empower Marriage and Family Therapy students and systematically introduce students to feminist themes is described. Faculty in the university's theatre department recruit their students to serve as client families. Role-play exercises with theatre students based on vignettes developed by clinical faculty increases realism and includes other training benefits. This approach is consistent with a feminist model of training and supervision.     

Spirituality in MFT Training: Development of the Spiritual Issues in Supervision Scale

As spirituality moves increasingly to the forefront of the body of marriage and family therapy (MFT) literature, many clinicians still find it uncomfortable or difficult to address spirituality in therapy. This study presents a new measure—the Spiritual Issues in Supervision Scale (SISS)—that examines supervisees' perceptions of the degree to which spirituality is addressed in supervision. Researchers distributed the SISS to mental health professionals around the United States who either were receiving supervision currently or had received supervision recently from professionals in their fields or programs. Results indicated that the new instrument has evidence of reliability and validity.     

Breaking Up Is Hard to Do: Dismissing Students From MFT Training Programs

Dismissing a student from an MFT training program can be challenging from an ethical and professional perspective. A thorough review of the literature regarding dismissal procedures in MFT training programs was conducted in order to increase discussion around circumstances under which dismissal is warranted and necessary for the protection of the public, the student, and the profession with specific attention to the dismissal process. The authors present the current state of the literature, include a case scenario for facilitating a conversation about this topic, and provide guiding principles for faculty and supervisors who might engage in a dismissal process.     

The Appropriate Use and Misuse of Social Media in MFT Training Programs: Problems and Prevention

Directors of accredited marriage and family therapy programs were surveyed to determine what problems they had experienced resulting from student, faculty, and client misuse of social media. Approximately 40 % of the programs had encountered a problem resulting from student misuse of social media. The directors were also asked what efforts were made by their program and university to promote the appropriate use of social media, with programs assuming primary responsibility for addressing this issue. The study also assessed attitudes among directors regarding how to handle potential issues that may arise in training programs regarding the use of social media. Implications for training programs are provided.     

Discussions of Diversity in a Classroom: A Phenomenological Study of Students in an MFT Training Program

Discussions about diversity, particularly race, gender, religion and spirituality, and sexual orientation, in marriage and family therapy courses can generate emotional responses in students and professors that vary from shame to anger. These discussions are necessary to help students understand diverse families as well as how one’s biases can affect his/her clinical work. Our qualitative study consisted of phenomenological interviews, which focused on discussions of diversity by six students from a marriage and family therapy program. Findings revealed that the ability of students to be aware of and discuss their reactions to these discussions is complex and influenced by their families of origin, their perceptions of other students, their views of the professor, and their race. Teaching implications are discussed in light of these findings.     

Position Location on Topographical Maps: Effects of Task Factors,Training, and Strategies

There is little research on the ways people go about the very common task of extracting information from various forms of maps. In this study, we examined task factors, cognitive processes, and individual differences as determinants of performance differences when locating a position on a topographical map from a given position on the ground. Subjects for the study were 188 Australian Army personnel. Both spatial visualization ability and a visual learning style preference were found to be effective predictors of performance, whereas a form of verbal strategy training produced significantly improved performance. When no effective strategy was supplied, those subjects with a strong visual learning style preference performed dramatically better than their low-preference counterparts, suggesting that this form of processing preference may have a powerful impact on untrained performance. These results indicate that most subjects usually approach the task of map reading in a relatively passive way, without any coherent strategy, and then attempt to encode information using inefficient spatial codes. When a simple and effective verbal strategy was supplied, most subjects were able to adopt it, with uniformly beneficial, results. This suggests that performance on many spatial tasks could be improved by verbal strategy training.     

SHORES: A Practical Mnemonic for Suicide Protective Factors

Guidelines for addressing and managing client suicide risk include discussing and conceptualizing protective factors. Counselors should be able to recall and discuss suicide protective factors that are applicable across client populations. SHORES, a suicide protective factors mnemonic that is supported by the literature, has applications for risk assessment and crisis intervention across settings, preventative care, strengths‐based management, and counselor training. A case example and discussion serve to illustrate the wide‐ranging application of SHORES in counseling practice.     

Implementing the Boulder Model of Training in a Psychology Training Clinic

The scientist–practitioner (S–P) model of training has guided professional psychology in the United States for nearly six decades. However, since its inception, the model has been hotly debated and implementation of the model has been chronically problematic. One counseling psychologist who is working as both a faculty member and psychology training clinic director describes how scientific principles can be retained in a practice setting. He overviews the Boulder model of training, provides a brief review of the psychology training clinic (PTC), describes his current work setting and unique faculty appointment, and outlines five strategies for integrating science and practice in applied clinical settings. He also highlights how embracing the Boulder model has promoted a strong professional identity and presents the PTC as a model professional home for S–Ps.     

Look Who's Talking: Measuring Self-Disclosure in MFT

While self-disclosure plays a prominent role in the development and maintenance of the therapeutic relationship, most marriage and family therapy clinical research fails to include measures of self-disclosure. A factor analysis of Chelune's (1976) Self Disclosure Situations Survey (SDSS) reduces the number of items in this measure from 20 to six. Researchers are encouraged to consider conducting clinical research with specific attention to the construct of self-disclosure. The revised SDSS could easily be added as part of the self-report information collected in clinical studies.     

维护共同利益：医学道德存在的现实基础

我们为什么需要医学道德 ?作为医务人员处理医患关系的行为准则 ,究竟是一种社会的外在要求 ,还是一种与行业生存、发展有关的内在要求 ,或者是两者兼而有之 ?要准确地回答这些问题并不容易 ,这需要我们去探讨医学道德的本质和存在的现实基础。搞清楚这些问题 ,或许能帮助我们解决在临床医疗道德实践中碰到的各种难题和困惑。1　临床医学道德实践中产生的问题在处理医患关系的矛盾和冲突时 ,社会和医疗管理部门会对医务人员提出这样或那样的道德要求。对此 ,有人常常会问 ,为什么在医患关系中总是要强调维护病人的利益 ?医生是一种职业 ,还…     

Multi-domain Models of Risk Factors for Depression and Anxiety Symptoms in Preschoolers: Evidence for Common and Specific Factors

Relatively few studies have examined multiple pathways by which risk factors from different domains are related to symptoms of anxiety and depression in young children; even fewer have assessed risks for these symptoms specifically, rather than for internalizing symptoms in general. We examined a theoretically- and empirically-based model of variables associated with these symptom types in a diverse community sample of 796 4-year-olds (391 boys, 405 girls) that included factors from the following domains: contextual (SES, stress and family conflict); parent characteristics (parental depression); parenting (support/engagement, hostility and scaffolding); and child characteristics including negative affect (NA) effortful control (EC) sensory regulation (SR), inhibitory control (IC) and attachment. We also compared the models to determine which variables contribute to a common correlates of symptoms of anxiety or depression, and which correlates differentiate between those symptom types. In the best-fitting model for these symptom types (a) SES, stress and conflict had indirect effects on both symptom types via long-chain paths; (b) caregiver depression had direct effects and indirect ones (mediated through parenting and child effortful control) on both symptom types; (c) parenting had direct and indirect effects (via temperament and SR); and temperament had direct effects on both symptom types. These data provide evidence of common risk factors, as well as indicate some specific pathways/mediators for the different symptom types. EC was related to anxiety, but not depression symptoms, suggesting that strategies to improve child EC may be particularly effective for treatment of anxiety symptoms in young children.     

A Method for Tracking Implementation Strategies: An Exemplar Implementing Measurement-Based Care in Community Behavioral Health Clinics

Implementation experts suggest tailoring strategies to the intended context may enhance outcomes. However, it remains unclear which strategies are best suited to address specific barriers to implementation, in part because few measurement methods exist that adhere to recommendations for reporting. In the context of a dynamic cluster randomized trial comparing a standardized to tailored approach to implementing measurement-based care (MBC), this study aimed to (a) describe a method for tracking implementation strategies, (b) demonstrate the method by tracking strategies generated by teams tasked with implementing MBC at their clinics in the tailored condition, and (c) conduct preliminary examinations of the relation between strategy use and implementation outcomes (i.e., self-reported fidelity to MBC). The method consisted of a coding form based on Proctor, Powell, and McMillen (2013) implementation strategy reporting guidelines and Powell et al.’s (2012) taxonomy to facilitate specification of the strategies. A trained research specialist coded digitally recorded implementation team meetings. The method allowed for the following characterization of strategy use. Each site generated 39 unique strategies across an average of six meetings in five months. There was little variability in the use of types of implementation strategies across sites with the following order of prevalence: quality management (50.00%), restructuring (16.53%), communication (15.68%), education (8.90%), planning (7.20%), and financing (1.69%). We identified a new category of strategies not captured by the existing taxonomy, labeled “communication.” There was no evidence that number of implementation strategies enacted was statistically significantly associated with changes in self-reported fidelity to MBC—however, financing strategies were associated with increased fidelity. This method has the capacity to yield rich data that will inform investigations into tailored implementation approaches.     

Implementing Parent Management Training in the Context of Poverty

Parent management training (PMT) is a well-investigated, effective, and preferred treatment for children's externalizing behaviors and related disorders. Unfortunately, PMT is not as effective for children living in poor families, who disproportionately exhibit the behaviors that PMT is designed to correct. We suggest that PMT is less successful for poor children because (1) the same factors that explain the relation between economic hardship and children's externalizing behaviors also are related to unsuccessful PMT outcomes; and (2) PMT interventions are less acceptable to poor parents, and therefore less likely to be adopted. Clinical implications are drawn from the analysis.

     

NEW CONCEPTUALIZATIONS OF PRACTICE: Common Principles in Three Paradigms Suggest New Concepts for Training

We argue herein that typical training procedures are far from optimal. The goal of training in real-world settings is, or should be, to support two aspects of posttraining performance: (a) the level of performance in the long term and (h) the capability to transfer that training to related tasks and altered contexts. The implicit or explicit assumption of those persons responsible for training is that the procedures that enhance performance and speed improvement during training will necessarily achieve these two goals. However, a variety of experiments on motor and verbal learning indicate that this assumption is often incorrect. Manipulations that maximize performance during training can be detrimental in the long term: conversely, manipulations that degrade the speed of acquisition can support the long-term goals of training. The fact that there are parallel findings in the motor and verbal domains suggests that principles of considerable generality can be deduced to upgrade training procedures.     

Family Survivors of Homicide: II. Practical Therapeutic Strategies

As more and more mental health clinicians become involved in the criminal justice system, family therapists will see increasing numbers of crime victims in their caseloads, and some of these families will have lost loved ones to murder. Part I of this two-part article described the common and atypical symptoms, syndromes, and reaction patterns shown by families who have experienced the murder of a loved one. Part II presents a practical model for treating family survivors of homicide that incorporates cognitive-behavioral, psychodynamic, family systems, and existential components. Throughout, the emphasis is on therapists being equipped with a sufficiently broad range of clinical tools to treat these survivors flexibly, effectively, competently, and compassionately.